Marriage and struggles with religion and spirituality significantly raise the suicide risk for veterans, according to a study funded by the U.S. Department of Veterans Affairs.

“Transitioning back into a domestic home environment may prove exceedingly difficult,” resulting in an increased suicide risk for veterans who are married or living with a partner, the study states.

In addition, suicide risk rises substantially for veterans undergoing strains in their religious and spiritual lives, the study shows. Such strains include beliefs expressed by veterans that they have been abandoned by God, that God doesn’t love them or is punishing them.

On the other hand, no effect on suicide risk was seen when veterans reported positive religious and spiritual connections.

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The study found that women in their fifties were at highest risk of suicide.

A total of 772 post 9-11 veterans were surveyed by telephone, with more than 20 percent seen at risk of suicide after reporting that they have recently wished they were dead, have had thoughts of suicide and/or had attempted suicide.

The focus of the study was on the connection between veterans’ suicide and struggles with religion and spirituality, but a range of questions was asked.

Crystal Park, a University of Connecticut psychology professor and senior study investigator, said in light of the “really shocking” problem of veterans’ suicide, researchers were trying to identify factors that could be addressed in suicide prevention efforts. She said there has been “surprisingly little” research about religion’s link to suicide despite the fact that religion is important to many military members.

Between 2001 and 2014, suicide increased by 62.4 percent among female veterans and 29.7 percent among male veterans, according to VA statistics.

Nearly 42 percent of participants in the study were female. With the female military population increasing, “concern is rising regarding whether and how earlier understanding of suicide risk factors might be moderated by gender,” the study states.

Most recent VA statistics report 2 million women veterans, 9.4 percent of all veterans. By 2043, the VA predicts that women will be 16.3 percent of the veteran population.

The study was based at the VA in West Haven with chief investigator Rani A. Hoff, a Yale Medical School psychiatry professor and director of the VA’s Northeast Program Evaluation Center.

It found that of married veterans, women averaging age 50 were at highest risk of suicide. Park said that this could be less about age than the fact that many Reservists and National Guard members had enlisted prior to 9-11, and “never thought they would be deployed.” She said it is a “very different group from 20-year-olds who signed up after high school.”

A new research paper by the Resilience Center for Veterans and Families at Columbia University Teachers College concludes that post 9-11 veterans experience more stress while transitioning home than veterans of previous eras.

The research paper notes that transition stress is more prevalent than Post Traumatic Stress Disorder (PTSD), which receives more attention. It states that between 5 percent and 20 percent of post 9-11 veterans endure PTSD while 44 percent to 72 percent experience high stress levels from military separation and readjusting to civilian life. “Treatments and supports need to move beyond their nearly exclusive focus on PTSD” to also address transition stress, the study states. “Soldiers and veterans are undeniably resilient,” it states, but adds that “they’re not superhuman.”

Park, of UConn, agreed. “When you’re talking about people being stressed to the point where they’re thinking about killing themselves, we should be paying attention to that for sure,” she said.

Female veterans marry and divorce more than civilian women. As of 2015, 84 percent of women veterans were married, divorced, widowed or separated compared to 72 percent of civilian women, according to VA statistics. Some 23.4 percent of women veterans are divorced compared to 12.6 percent of civilian women, the statistics show.

The VA study estimates that 20 veterans commit suicide every day, representing 18 percent of suicides in the country.

It calls the link between religion and suicidal behavior “a novel and promising avenue for mitigating suicide risk in veterans.” Park suggested that veterans with spiritual struggles could be helped if they discuss those problems with clergy or secular therapists. However, she said “a lot of therapists aren’t comfortable dealing with religious issues.”

She pointed out that the study didn’t delve into reasons for veterans’ spiritual strains. “It suggests a deeper look” through research, she said. She speculated that it could be associated with “moral injuries people come back with” after doing or seeing things in combat that violate their sense of morality.

Park said she was surprised that the study found that positive religious and spiritual behavior had no effect on suicide risk. Such positive experience was defined in the study as: feeling part of a larger spiritual force, which could include atheism and agnosticism; considering God as a partner; and looking to God for strength, support and guidance.

“It was a little disappointing in the sense that it is not providing any particular help or advantage to people,” Park said.

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